A.—4a

8

Treatment : Medical. As already mentioned, the general attendance has fallen off, but there has been a substantial increase in admissions. The number of cases of lobar pneumonia admitted is slightly below that of last year, being 41 as against 46, though this year there is only 1 death to record from this cause as against 7 last year. Bronchitis shows an advance of 14 on last year's figures—so against 36 —with I death. The most marked feature, however, is the large increase in the number of cases of phthisis pulmonalis admitted, which total 27 —just three times the number for last year. It is difficult to account for this, as the seasons were normal. The fact that there were no deaths in hospital from this disorder is easily explained, as Samoans naturally prefer to die in their own houses, and consequently when the relatives realize that the case is hopeless they immediately remove the patient, only to die outside. Enteric fever accounts for 22 cases, 9of which occurred in a girl's high school, as has already been referred to. Six cases of poisoning by Samoan remedies were admitted, of whom 3 died shortly after admission. It is evident that the Samoans do not know of any safe dosage in administering their Native remedies. Treatment : Surgical. The work done in this Department has again been excellent. The number of major operations increased by 85 as compared with last year's figures (256-171). A very large proportion of the operations were performed under local anaesthesia, with results gratifying to both surgeon and patient. There is a noticeable increase in the number of hydroceles, no fewer than 61 having been operated upon. Abscesses again figure largely, and are one of the commonest ailments in these islands. It is here noted that they are not considered to be of filarial origin, but due to a staphylococcal infection, a fact which is corroborated by Dr. P. A. Buxton in his recently published second volume of " Researches in Melanesia and Polynesia." Six cases in all of malignant disease were met with, one death occurring. Chinese Coolies. There is a decided increase here in admissions to the wards, due to the arrival of a transport from Hong Kong in April last, the newly arrived coolies being very prone to sores which are invariably very septic on admission. Apia Hospital : Attendance, Operations, etc., por Year, 1928. General attendances — Out-patient attendances — European and Samoan .. .. .. .. 16,691 Chinese and Melanesian . . .. .. . . 173 Out-patient dressings (European and Samoan) .. 15,289 N.A.B. injections — First injections .. . , .. .. 1,488 Second injections .. .. .. .. 1,401 Third injections .. .. .. .. 1,232 4,121 Injectionsxfor elephantoid fever .. .. .. .. 25 X-rays .. .. .. .. .. .. 41 36,340 European in-patients .. .. .. .. .. .. 295 Samoan in-patients .. .. .. .. .. . . 715 Chinese and Melanesian in-patients .. .. .. .. .. 403 Treatments for hookworm .. .. .. .. .. .. 43 Operations — Major .. .. .. .. .. .. .. 256 Minor .. .. .. .. .. .. .. 656 Report op the Laboratory, Government Hospital, Apia, 1928. The total of routine specimens recorded is 1,460. The specimens comprise the following :— Eseces : Total specimens examined, 164. Ova (each specimen examined by direct smear and Willis method) : Hookworm (positive), 31 ; ascaris ova (positive), 3 ; trichuris (positive), 11. Adult worms : In many cases 3 specimens obtained after treatment were examined. Hookworm (positive), 6 ; ascaris (positive), 4 ; trichuris (positive), 3. Occult blood (positive), 10. Bacteriological examinations : Positive T. 8., 1 ; B. dysenteries, " shiga " (positive), 2 (in both specimens the organism was confirmed by fermentation reactions and agglutination tests) ; E. hystolytica (positive), 1 ; 11. typhosus (positive), 11. A total of 63 specimens of faeces were examined for typhosus, the positives being confirmed by agglutination tests. Chemical examination, 1. Examination for fat, tissue, and cells, 3. Urines : Total specimens examined, 783, containing —albumen, 615 ; sugar, 14 ; blood, 64 ; bile, II ; acetone, 2. Centrifuged deposits were examined in all but 43 of the specimens. Those containing pus cells, 410 ; casts, 66. Bacteriological reports were made from smears in non-catheter specimens, and cultures in the case of catheter specimens. Organisms present : B. coli, 78 ; streptococci, 26 ; staphylococci, 44 ; gonococci, 11 ; T. 8., 1. Sputa: Number examined, 136. Gram and Ziehl Neelson smears were prepared. from each specimen, while cultures were prepared from 16. Number positive for T. 8., 22.